Khan Mohammed Yunus, Pandit Sucheta, Jayagopal P B, Oomman Abraham, Chockalingam Kulasekaran C, Ramakrishnan Anantharaman, Mane Amey, Mehta Suyog, Shah Snehal
Dr. Reddy's Laboratories Ltd, Hyderabad, Telangana.
Lakshmi Hospital, Palakkad, Kerala.
J Assoc Physicians India. 2020 Aug;68(8):66-72.
Real-world data on the effectiveness of antihypertensive drugs (AHDs) in India is limited. The present study aims to provide updated evidence regarding the effectiveness of olmesartan as monotherapy or in combination with other AHDs in Indian patients with essential hypertension.
Electronic medical record data of adult patients who were diagnosed with essential hypertension (≥140/90 mmHg) and were prescribed olmesartan as mono- or add-on therapy were retrospectively analyzed. Patients were classified based on the number of AHD classes prescribed on initiation of olmesartan. Change in systolic and diastolic blood pressure (SBP and DBP) from baseline was the primary endpoint. Secondary endpoint was evaluation of proportion of patients who achieved treatment goals as per 2018 European Society of Cardiology/European Society of Hypertension guidelines. Readings were obtained before initiating olmesartan and after at least a month of therapy with olmesartan.
Among the 459 included patients, majority were on olmesartan monotherapy or olmesartan+1AHD (91.7%). Mean (95% confidence interval [CI]) change in olmesartan monotherapy group was: SBP (-13.4 [-15.7, -11.1] mmHg) and DBP (-8.3 [-9.5, -7.1] mmHg) and mean (95% CI) change in olmesartan+1AHD group was: SBP (-11.7 [-15.1, -8.3] mmHg) and DBP (-6.6 [-8.3, -4.9] mmHg) (P<0.001 for all). SBP and DBP goals were achieved by 40.4% and 50.3% of patients on olmesartan monotherapy and by 36.1% and 46.2% of patients on olmesartan+1AHD. Among patients with comorbid diabetes, mean (95% CI) change in olmesartan monotherapy group was: SBP (-15.5 [-18.6, -12.4] mmHg) and DBP (-8.7 [-10.2, -7.2] mmHg) and mean (95% CI) change in olmesartan+1AHD group was: SBP (-13.5 [-18.3, -8.7] mmHg) and DBP (-7.6 [-9.8, -5.4] mmHg) (P<0.001 for all). SBP and DBP goals were achieved by 38.5% and 49.4% of patients on olmesartan monotherapy and by 31.7% and 42.9% of patients on olmesartan+1AHD.
Olmesartan prescribed as mono- or add-on therapy during routine clinical practice significantly reduced blood pressure in Indian patients with essential hypertension as well as in patients with comorbid diabetes.
关于抗高血压药物（AHDs）在印度有效性的真实世界数据有限。本研究旨在提供关于奥美沙坦作为单一疗法或与其他AHDs联合用于印度原发性高血压患者有效性的最新证据。
对诊断为原发性高血压（≥140/90 mmHg）且被处方使用奥美沙坦作为单一疗法或附加疗法的成年患者的电子病历数据进行回顾性分析。根据开始使用奥美沙坦时所处方的AHD类别数量对患者进行分类。收缩压和舒张压（SBP和DBP）相对于基线的变化是主要终点。次要终点是根据2018年欧洲心脏病学会/欧洲高血压学会指南评估达到治疗目标的患者比例。在开始使用奥美沙坦之前以及使用奥美沙坦至少一个月后获取读数。
在纳入的459例患者中，大多数接受奥美沙坦单一疗法或奥美沙坦 + 1种AHD治疗（91.7%）。奥美沙坦单一疗法组的平均（95%置信区间[CI]）变化为：SBP（-13.4 [-15.7, -11.1] mmHg）和DBP（-8.3 [-9.5, -7.1] mmHg），奥美沙坦 + 1种AHD组的平均（95% CI）变化为：SBP（-11.7 [-15.1, -8.3] mmHg）和DBP（-6.6 [-8.3, -4.9] mmHg）（所有P<0.001）。奥美沙坦单一疗法组40.4%和50.3%的患者达到SBP和DBP目标，奥美沙坦 + 1种AHD组36.1%和46.2%的患者达到目标。在合并糖尿病的患者中，奥美沙坦单一疗法组的平均（95% CI）变化为：SBP（-15.5 [-18.6, -12.4] mmHg）和DBP（-8.7 [-10.2, -7.2] mmHg），奥美沙坦 + 1种AHD组的平均（95% CI）变化为：SBP（-13.5 [-18.3, -8.7] mmHg）和DBP（-7.6 [-9.8, -5.4] mmHg）（所有P<0.001）。奥美沙坦单一疗法组38.5%和49.4%的患者达到SBP和DBP目标，奥美沙坦 + 1种AHD组31.7%和42.9%的患者达到目标。
在常规临床实践中作为单一疗法或附加疗法处方的奥美沙坦可显著降低印度原发性高血压患者以及合并糖尿病患者的血压。
